Lachs MS, Han SD.

Various processes common in the aging brain may affect an older adult’s ability to manage personal finances, the most recognized of which are dementing illnesses (1). These conditions can affect cognitive abilities, which may jeopardize an older adult’s financial well-being over their longitudinal course. However, recent studies suggest that even cognitively intact older adults can have “functional” changes that may render them financially vulnerable. Social isolation also increases dramatically with age, which places older persons at risk for exploitation from predators. Furthermore, capitalistic enterprises can threaten the financial security of this group, which is perceived to be a large untapped market and, in an era of information overload, is often presented with a dizzying array of
products and services.

We propose the concept of age-associated financial vulnerability (AAFV) and discuss aspects of its epidemiology from the vantage of a neuropsychologist (S.D.H) and geriatrician–epidemiologist (M.S.L) who are both researchers and clinicians working in the field of elder abuse. We  believe that considering AAFV a clinical syndrome may be advantageous to further critical research, promote public policy work, and encourage physicians to recognize it.

Conclusions and Future Directions
We believe that AAFV is a problem with serious effects on patients, their families, and society. Its roots reside in the curious intersection of several trends, including a rapidly
aging society, age-associated changes in the human brain, shifts in the concentration of wealth to older demographic groups, and industry’s adoption of marketing strategies that are
increasingly becoming rooted in behavioral economics and cognitive neuroscience. Although some protective efforts have been made on the federal level (9) (for example,
passage of the Elder Justice Act) as well as in business (for example, the Better Business Bureau) and academia (for example, Baylor College of Medicine’s financial exploitation
education program for physicians and other professionals) (10), progress is urgently needed on several other fronts. Research must be done to better understand whether AAFV is a
clinical syndrome, determine who is at risk and why, and create screening and intervention programs using strategies similar to those used recently for financial exploitation (4). The
role and responsibilities of physicians in protecting their patients with AAFV must be defined and supported with evidence-based tools. Given the public health and policy implications of AAFV, a rigorous debate must begin on how to balance protection of older adults with the autonomy afforded to all citizens.

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